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Severe Isolated Cardiomyopathy Requiring Heart Transplant Following COVID-19 Infection and Subsequent Vaccination
INTRODUCTION: Cardiomyopathy is a known complication associated with COVID-19, and 7% of all COVID-19 related deaths are thought to be due to myocarditis. There is also growing evidence for COVID-19 vaccine-related myocarditis. We present the first case of a patient with severe isolated cardiomyopat...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Published by Elsevier Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988570/ http://dx.doi.org/10.1016/j.healun.2022.01.1700 |
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author | Mitchel, H. Patalinghug, P. Berthiaume, K. Morris, M. Kalya, A. Arabia, F. Gopalan, R. |
author_facet | Mitchel, H. Patalinghug, P. Berthiaume, K. Morris, M. Kalya, A. Arabia, F. Gopalan, R. |
author_sort | Mitchel, H. |
collection | PubMed |
description | INTRODUCTION: Cardiomyopathy is a known complication associated with COVID-19, and 7% of all COVID-19 related deaths are thought to be due to myocarditis. There is also growing evidence for COVID-19 vaccine-related myocarditis. We present the first case of a patient with severe isolated cardiomyopathy requiring heart transplant after both COVID-19 infection and vaccination. CASE REPORT: A 58-year-old male with no prior medical history was diagnosed with COVID-19 infection in December 2020 without hospitalization. He experienced declining symptoms over the next 7 months and completed COVID-19 vaccination in July. On 8/10/2021, he presented to the emergency room with worsening exertional dyspnea and orthopnea. Initial labs revealed elevated NT-proBNP (1,701 pg/mL) and high-sensitivity cardiac troponin-T (45 ng/L). Transthoracic echocardiography revealed reduced left ventricular (LV) ejection fraction at 15% and LV end-diastolic diameter at 5.6 cm. Coronaries were clear. Cardiac MRI (cMR) is depicted in Figure 1. He was managed with an Impella device and dobutamine but failed weaning from this cardiac support. He was listed for transplant as UNOS Status 2 and underwent successful OHT on 9/19/2021. SUMMARY: Acute myocardial injury is known to be a frequent complication during the COVID-19 course, but it is not known to require advanced therapies. There is only one other case from France that describes a patient bridged with temporary mechanical support to OHT following COVID-19 induced cardiomyopathy. In both cases, cMR revealed similar late gadolinium enhancement (LGE) patterns. The cases differ as our patient experienced Long COVID symptoms over 8 months after diagnosis and was vaccinated while the French report describes a patient who was diagnosed with COVID-19, experienced end-stage heart failure and underwent transplant all within 11 days. This case contributes to the lacunae in data in the era of COVID-19 and its vaccines. |
format | Online Article Text |
id | pubmed-8988570 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89885702022-04-11 Severe Isolated Cardiomyopathy Requiring Heart Transplant Following COVID-19 Infection and Subsequent Vaccination Mitchel, H. Patalinghug, P. Berthiaume, K. Morris, M. Kalya, A. Arabia, F. Gopalan, R. J Heart Lung Transplant (521) INTRODUCTION: Cardiomyopathy is a known complication associated with COVID-19, and 7% of all COVID-19 related deaths are thought to be due to myocarditis. There is also growing evidence for COVID-19 vaccine-related myocarditis. We present the first case of a patient with severe isolated cardiomyopathy requiring heart transplant after both COVID-19 infection and vaccination. CASE REPORT: A 58-year-old male with no prior medical history was diagnosed with COVID-19 infection in December 2020 without hospitalization. He experienced declining symptoms over the next 7 months and completed COVID-19 vaccination in July. On 8/10/2021, he presented to the emergency room with worsening exertional dyspnea and orthopnea. Initial labs revealed elevated NT-proBNP (1,701 pg/mL) and high-sensitivity cardiac troponin-T (45 ng/L). Transthoracic echocardiography revealed reduced left ventricular (LV) ejection fraction at 15% and LV end-diastolic diameter at 5.6 cm. Coronaries were clear. Cardiac MRI (cMR) is depicted in Figure 1. He was managed with an Impella device and dobutamine but failed weaning from this cardiac support. He was listed for transplant as UNOS Status 2 and underwent successful OHT on 9/19/2021. SUMMARY: Acute myocardial injury is known to be a frequent complication during the COVID-19 course, but it is not known to require advanced therapies. There is only one other case from France that describes a patient bridged with temporary mechanical support to OHT following COVID-19 induced cardiomyopathy. In both cases, cMR revealed similar late gadolinium enhancement (LGE) patterns. The cases differ as our patient experienced Long COVID symptoms over 8 months after diagnosis and was vaccinated while the French report describes a patient who was diagnosed with COVID-19, experienced end-stage heart failure and underwent transplant all within 11 days. This case contributes to the lacunae in data in the era of COVID-19 and its vaccines. Published by Elsevier Inc. 2022-04 2022-04-07 /pmc/articles/PMC8988570/ http://dx.doi.org/10.1016/j.healun.2022.01.1700 Text en Copyright © 2022 Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | (521) Mitchel, H. Patalinghug, P. Berthiaume, K. Morris, M. Kalya, A. Arabia, F. Gopalan, R. Severe Isolated Cardiomyopathy Requiring Heart Transplant Following COVID-19 Infection and Subsequent Vaccination |
title | Severe Isolated Cardiomyopathy Requiring Heart Transplant Following COVID-19 Infection and Subsequent Vaccination |
title_full | Severe Isolated Cardiomyopathy Requiring Heart Transplant Following COVID-19 Infection and Subsequent Vaccination |
title_fullStr | Severe Isolated Cardiomyopathy Requiring Heart Transplant Following COVID-19 Infection and Subsequent Vaccination |
title_full_unstemmed | Severe Isolated Cardiomyopathy Requiring Heart Transplant Following COVID-19 Infection and Subsequent Vaccination |
title_short | Severe Isolated Cardiomyopathy Requiring Heart Transplant Following COVID-19 Infection and Subsequent Vaccination |
title_sort | severe isolated cardiomyopathy requiring heart transplant following covid-19 infection and subsequent vaccination |
topic | (521) |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988570/ http://dx.doi.org/10.1016/j.healun.2022.01.1700 |
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